Provider Demographics
NPI:1457932881
Name:CAPSTONE HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:CAPSTONE HOME HEALTHCARE LLC
Other - Org Name:CAPSTONE HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHINENYE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESOMONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-596-0023
Mailing Address - Street 1:9310 OLD KINGS RD S STE 1703
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9310 OLD KINGS RD S STE 1703
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8101
Practice Address - Country:US
Practice Address - Phone:904-596-0023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health